FDA Adverse Event Malfunction Summary report: N

GOLDLINE REUSABLE PUSH BUTTON ELECTROSURGICAL PENCIL

MDR report key: 3083318 · Received April 29, 2013

Report

Report Number
3007305485-2013-00043
Event Type
Malfunction
Date Received
April 29, 2013
Date of Event
February 15, 2013
Report Date
May 24, 2013
Manufacturer
CONMED ELECTROSURGERY
Product Code
GEI
PMA / PMN Number
K791137
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THIS IS AN FDA REPORTABLE EVENT DUE TO A SENTINEL EVENT REPORTED ON MEDWATCH 1720159-2011-00057. THE DEVICE IS EXPECTED; HOWEVER, HAS NOT YET BEEN RECEIVED BY CONMED CORPORATION. UPON COMPLETION OF THE QUALITY ENGINEERING EVALUATION, A SUPPLEMENTAL REPORT WILL BE FILED. NOT YET RECEIVED AT CONMED.

Additional Manufacturer Narrative · 1

THE DEVICE IN QUESTION IS DESIGNED TO BE USED AS ACCESSORIES IN CONJUNCTION WITH THE ELECTROSURGICAL UNITS AND ELECTRODES WITH WHICH THEY ARE KNOWN TO BE COMPATIBLE. THEIR USE ENABLES THE OPERATOR TO REMOTELY CONDUCT AN ELECTROSURGICAL CURRENT FROM THE OUTPUT CONNECTOR OF AN ELECTROSURGICAL UNIT TO THE OPERATIVE SITE FOR THE DESIRED SURGICAL EFFECT. THESE DEVICES ARE COMPATIBLE WITH CONMED DISPOSABLE STANDARD AND ULTRACLEAN ACTIVE ELECTRODES. A DHR/LHR, DEVICE HISTORY RECORD/LOT HISTORY RECORD, REVIEW WAS NOT ACCOMPLISHED FOR THE LOT NUMBER WAS NOT MADE AVAILABLE. ONE (1) USED DEVICE WAS RETURNED TO CONMED COMPLAINT CENTER FOR INVESTIGATION. THE RETURNED DEVICE WAS EXAMINED IN THE LABORATORY. THE COMPLAINT PRODUCT WAS CONNECTED TO AN ESU, ELECTROSURGICAL UNIT, & A STEEL GROUNDING PLATE. THE CUT & COAG FUNCTION OF THE COMPLAINT DEVICE WAS CHECKED AT VARIOUS POWER SETTINGS. NO CUT OR COAG DISCREPANCIES WERE OBSERVED DURING THE EXAMINATION. AUTO/SELF ACTIVATION OF THE CUT OR COAG FUNCTION WAS NOT OBSERVED DURING THE TESTING. THERE COULD BE MULTIPLE OF POSSIBLE CAUSES FOR THIS FAILURE MODE. IMPROPERLY ASSEMBLED DEVICE COULD BE POSSIBLE CAUSE FOR THIS FAILURE MODE. THE IFU, INSTRUCTIONS FOR USE, SPECIFIES, "INSPECT AND TEST EACH DEVICE BEFORE USE". THUS, ANY DEVICE DISCREPANCIES SHOULD BE DETECTABLE PRIOR TO USE. THE IFU ALSO SPECIFIES, "USE LOWEST POSSIBLE POWER SETTING ON THE ASSOCIATED ELECTROSURGICAL UNIT CAPABLE OF ACHIEVING DESIRED SURGICAL EFFECT. ACTIVATION TIME SHOULD BE AS SHORT AS POSSIBLE". FURTHERMORE, PROPER CLEANING AND STERILIZATION TECHNIQUES ARE LISTED IN THE IFU. IMPROPERLY FOLLOWED CLEANING AND STERILIZATION DIRECTIONS COULD CAUSE A NON-FUNCTIONAL DEVICE. THE CUT & COAG FUNCTION WORKED AS INTENDED DURING THE PRODUCT TESTING. THE COMPLAINT FAILURE MODE WAS NOT REPRODUCED DURING THE EXAMINATION. NO CORRECTIVE ACTION IS RECOMMENDED AT THIS TIME. CONMED IS CONSIDERING THIS COMPLAINT CLOSED.

Description of Event or Problem · 1

IT WAS REPORTED, "130317 - THE NEW PENCIL OUTPUT WITHOUT PRESSING THE BUTTON WHEN IT WAS CONNECTED TO ESU". (ELECTROSURGICAL PENCIL SELF-ACTIVATION) IT WAS ALSO REPORTED THAT THERE WAS NO PATIENT INJURY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
185492 GOLDLINE REUSABLE PUSH BUTTON ELECTROSURGICAL PENCIL CAUTERY PENCIL GEI CONMED ELECTROSURGERY UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1